February 2019, Carmelo Hospital’s night view, one Hospital of Hope for thousands of HIV/AIDS and Tuberculosis patients. Carmelo Hospital located in the town of Chokwe, Gaza province, is a medical unit of reference for TB (Tuberculosis) and AIDS (Acquired Immune Deficiency Syndrome caused by the HIV). Carmelo is comprised of several activities among them Inpatient departments, Paediatrics Center, Children Support Center, medical consultations, a sophisticated laboratory and pharmacy. It is part of the National Program against Tuberculosis and Leprosy (PNCTL), registered in the National Health System and is operated and administered by the Daughters of Charity of St. Vincent de Paul in agreement with the Ministry of Health.

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Hospital of Hope: Fighting HIV/AIDS One by One

Ezio Gianni Murzi | Mozambique/Gaza/Limpopo, Mozambique

Hospital of Hope is an ongoing story of the rise of the Carmelo Hospital, and the fight against HIV/AIDS in Mozambique. It all goes back to 1979, when I sent Sister Maddalena to run the maternity in Chalacuane, which resulted in systemic change to the district healthcare services. In the early 90’s, the St. Vincent de Paul Daughters of Charity determined that nearly thirty percent of the patients admitted in Chalacuane had AIDS realizing the urgent need for a bigger and better equipped medical facility. In fact, dealing with the disease required change, both mentally and organisationally, to cope with AIDS testing and treatments. In the mid-ninteis, at the beginning of the HIV/AIDS pandemic, with support from the government, the Carmelo Hospital was established modifying a convent to solely treating tuberculosis and HIV/AIDS patients. It is led by Mozambican doctors, houses a sophisticated laboratory, a bakery for income generation, a child center hosting AIDS orphans, and a kitchen serving two meals a day to patients. Hospital social workers regularly visit patients’ families in their villages to monitor treatment compliance and provide healthcare guidance.

http://www.diocesitortona.it/news.php?id_news=2159&id_enti=1
http://www.hospitalcarmelo.org/carmelo/?paged=4&lang=en

The HIV pandemic brought societal and health delivery changes. The initial onslaught due to HIV caused a change in family patterns. Grandmothers had and still have to care for their daughters’ children, now orphans, with almost no income. Health units were not prepared lacking adequate diagnostic tools nor did they have enough supplies of the right drugs or trained personnel to prescribe them. In addition, health services had to scale up their outreach services, put together a case register for proper and regular follow up and organise a house by house or a village by village tracking system of defaulters. But not only. Regular monthly check ups and home visiting give better understanding of the economic situation of the child’s family nucleus and target financial support to build simple housing, or convince care givers of the need to be regular in administrating HIV treatment to children.

Reality is that today only thirty to thirty five percent of children are on HIV treatment, meaning only half the adults. And many children defaulting on their treatment die of HIV when we have the tools to effectively treat HIV. Issues are of different nature. Proximity to the health unit read the distance from the home village to the nearest health center is affecting compliance, availability of the right paediatric dosage and preparations of ART drugs, the stigma, ie, HIV being equalled to infidelity, thus women fearing to tell their husband that they are HIV positive. All this may require different solutions, eg, quality reference centres with right diagnostics, monthly check ups where cash, fortified food, school handbooks are handed out to support the care givers to continue seeking treatment and children be checked up.

Is it possible to change the trend in HIV related child mortality? Yes. It is possible. It needs vision, management, strategic thinking and continuity of quality care provided locally. All this is being addressed in the Carmelo Hospital of Chokwe where well-trained professional staff provide care of the highest quality through multi-sectoral approaches to give hope of survival to patients and their families — a truly hospital of hope.

http://www.hospitalcarmelo.org/carmelo/?&lang=en

 St. Vincent de Paul  Daughters of Charity

Sister Maddalena Serra, text adapted from Italian interview at

http://www.diocesitortona.it/news.php?id_news=2159&id_enti=1
http://www.hospitalcarmelo.org/carmelo/?paged=4&lang=en
 

Ezio Gianni Murzi

00393407677943

eziogianni@gmail.com

Sister Maddalena Serra, text adapted from Italian interview at http://www.diocesitortona.it/news.php?id_news=2159&id_enti=1
http://www.hospitalcarmelo.org/carmelo/?paged=4&lang=en
Hospital of Hope: The Story of Sister Maddalena
“The joint work of the Missionary Sisters Daughters of Charity and the Community of Sant‘Egidio has enabled this region of Africa to discover the true meaning of the word hope.”
Sister Maddalena Serra, an Italian nun of the Daughters of Charity of St. Vincent de Paul, is a key protagonist of this story. She has worked in the Limpopo district in southern Mozambique, a former Portuguese colony, for almost fifty years.
In 1977, I joined as Chief Health Physician of the Limpopo District, and in 1979 I sent Sister Maddalena to Chalacuane, a village in the interior of Mozambique, where she worked for fourteen years, day and night, as head nurse and mainly treating tuberculosis patients coming in from the district capital Chokwe. In 1993, she left Chalacuane and came back to Chokwe bringing with her the experience of treating patients with HIV and AIDS. At this time, she realised that a systemic change in the healthcare system had to occur to deal with these life-threatening and terminal illnesses.
Through the dedication and tireless efforts of Sister Maddalena, an agreement between the church and the government was struck and an abandoned nunnery was modified into a AIDS and TB dedicated hospital, the Carmelo Hospital, to release pressure on the old rural hospital that would continue to serve all non-AIDS patients.
The building formerly housed a convent of barefoot Carmelites who had left the country in 1976 at the height of communist rule. In 1993, the government returned it to the local church and the bishop of Xai-Xai Diocese gave it to the Sisters of Charity of St. Vincent who, after considerable renovations, opened the hospital on May 10, 1995. “Our purpose, as Daughters of Charity,” Sister Maddalena stresses, “is to help the poorest namely those suffering from tuberculosis and AIDS.”
The hospital has 115 beds, including paediatrics and outpatient clinics, and the Sisters have in their care 9,877 AIDS patients of whom 9,383 are on antiretroviral therapy.
“Our religious community consists of five nuns, I am the only Italian, then there are one Spanish, one Argentine and two Mozambican. The staff consists of about 70 lay people, most of them local. Two national of Mozambique are doctors graduated from the Catholic University of Beira, and another, Arturo, is completing his studies. The clinical director is the first of the two Mozambicans graduates. The hospital above all, follows pregnant women who are sick with AIDS.”
“In 1995," adds Sister Serra, “we were only able to diagnose AIDS, but we did not have the treatment.” Then, in 2002 the Community of Sant'Egidio arrived and activated the DREAM program, which ensures protocols for treating the disease and the supply of antiretroviral drugs. In 2005, the hospital was recognized by the state, which now pays professional staff salaries, namely to doctors and nurses.
The greatest achievement over the years is that ninety-nine percent of the children of women with AIDS are born healthy. “We currently have 679 children born sick and on antiretroviral therapy because they were born to mothers who were not treated during pregnancy.”
As far as the hospital's livelihood is concerned, the sisters have to roll up their sleeves because financial allocation from the state is not sufficient. Thanks to a Spanish entrepreneur, a bakery has been set up that employs fifteen people and allows them to bake about 25,000 bread rolls a day, which are sold throughout the neighbourhood for income generation. With the proceeds from the sale of bread, it is possible to pay the orderlies who work in the hospital. Crucial was the support of the Paris Motherhouse, which oversaw the plans for the bakery's construction. “Ours is an open community,” Sister Maddalena continues, “and lay people often come from various European countries to experience life with us.”
On March 12, 2021, the new molecular biology laboratory was inaugurated in the presence of the Minister of Health. The laboratory has the highest level in advanced diagnostics of tuberculosis, AIDS, and many other diseases.
 

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